A cataract is a clouding of the normally transparent lens inside the eye. To understand how a cataract affects vision, think of the eye as a camera. The camera focuses images onto film; the cornea and lens of the eye focus images on the retina. When the lens is clear, light passes through easily, and the image is clear. A cataract is like a dirty camera lens, it blocks light and the image becomes blurred and hazy.
Cataract develops gradually. At first it will not interfere with vision. As cataract grows vision will progressively deteriorate. Both eyes are usually affected but often at a different rate.
Symptoms of cataract include:
The only treatment for cataract is surgery. Neither stronger glasses nor medicines or laser are of help. With advances in cataract surgery it is no longer necessary to wait until your vision is severely impaired or for the cataract to "ripen" before having surgery.
I advise for cataracts to be removed once visual impairment interferes with your daily activities. The decision is for you to make depending on your individual visual expectations and needs. For some people, even a slight loss of sight is unacceptable and the decision to have surgery will come early. Others may choose not to have surgery because the cataract does not seriously interfere with their lives. The legal visual requirements to hold a driving licence may make cataract surgery necessary for you to continue to drive.
Surgery
The Anaesthetic
Local anaesthesia means that just the area of the operation is made numb. Anaesthetic is placed around your eye, NOT into your eye! This is a little uncomfortable for about 10 seconds but is not painful. The eye is numbed to pain and vision (you will not see the operation) and paralyses the muscles so that you cannot move the eye nor squeeze your lids. Then all you need to do is lie flat and relatively still. If you are a little apprehensive your anaesthetist can give a small sedative. During surgery you will be aware of the surroundings, sounds and feel my hands resting on your forehead.
The Operation
Through a tiny incision in the eye a small ultrasonic probe about the size of a pen tip breaks up the cataract into small pieces that are vacuumed up the probe. This is called phacoemulsification or phaco.
Symptoms of cataract include:
- Blurred or hazy vision
- Feeling of a film over the eye
- Frequent changes in the strength of your glasses
- Difficulty seeing in bright light
- Glare in sunlight or bright light, haloes or tails from car headlights at night
- Poorer colour vision
The only treatment for cataract is surgery. Neither stronger glasses nor medicines or laser are of help. With advances in cataract surgery it is no longer necessary to wait until your vision is severely impaired or for the cataract to "ripen" before having surgery.
I advise for cataracts to be removed once visual impairment interferes with your daily activities. The decision is for you to make depending on your individual visual expectations and needs. For some people, even a slight loss of sight is unacceptable and the decision to have surgery will come early. Others may choose not to have surgery because the cataract does not seriously interfere with their lives. The legal visual requirements to hold a driving licence may make cataract surgery necessary for you to continue to drive.
Surgery
The Anaesthetic
Local anaesthesia means that just the area of the operation is made numb. Anaesthetic is placed around your eye, NOT into your eye! This is a little uncomfortable for about 10 seconds but is not painful. The eye is numbed to pain and vision (you will not see the operation) and paralyses the muscles so that you cannot move the eye nor squeeze your lids. Then all you need to do is lie flat and relatively still. If you are a little apprehensive your anaesthetist can give a small sedative. During surgery you will be aware of the surroundings, sounds and feel my hands resting on your forehead.
The Operation
Through a tiny incision in the eye a small ultrasonic probe about the size of a pen tip breaks up the cataract into small pieces that are vacuumed up the probe. This is called phacoemulsification or phaco.
Once the cataract is removed I insert the lens implant and position it exactly central behind the pupil.
Finally the eye is covered with a pad which will be left on overnight.
After the Operation
You will be taken back to the lounge to have a drink, something to eat, and stay for a short period until you feel ready to leave. Full instructions for overnight care will be given. Ensure you have some Paracetamol (panadol) tablets at home in case required.
Overnight after Surgery
Rest quietly. You must have someone there to look after you for the first night.
The Day after Surgery
I will see you in the morning at Hamilton Eye Clinic to check your eye and explain the eye care instructions.
Recovery
Most patients see well enough to return to their routine activities within a day or so after surgery.
Your eye may be slightly irritable, light sensitive and red for the first week or so. This will gradually improve.
Glasses are updated after six weeks.
Follow-Up Visits
Risks
Thanks to recent advances, cataract surgery gives improvement in vision in over 97% of eyes and is without serious complication in more than 98% of cases. Before undergoing cataract surgery it is essential that you understand the risks involved.
Though cataract surgery is one of the safest forms of surgery, all surgical procedures have risk.
I attempt to minimize risk but complications can occur that may have permanent effects. When you are making the decision to have surgery, you must keep in mind that I cannot guarantee that surgery will always be successful or that surgery bears no risk. I will not describe at length every possible risk or rare complications. Sometimes such detail can be frightening.
Serious complications are uncommon because of the significant surgical advances in recent years. However, if complications do occur, vision may be impaired or even lost. Some people with certain pre-existing eye conditions are at greater risk. If one eye is blind (or has extremely poor vision), you must very carefully weigh the benefit against the risks of cataract surgery on your only "working" eye.
The risks of cataract surgery include:
Although most complications resolve following additional treatment and over time, they can affect vision, sometimes permanently.
Capsule Opacification
After surgery, the cataract cannot grow back. However a number of eyes develop a clouding of the lens capsule behind the implant. This is not a complication but a normal healing response in many eyes.
A cloudy capsule can take months or years to develop. You will notice blur or glare.
I can correct this using a laser to create a tiny opening in the capsule which allows light to pass through normally. This procedure is called a capsulotomy. This procedure takes only a few minutes and is painless. The improvement in vision can be seen at once. Complications can occur, but serious complcations are very uncommon.
After the Operation
You will be taken back to the lounge to have a drink, something to eat, and stay for a short period until you feel ready to leave. Full instructions for overnight care will be given. Ensure you have some Paracetamol (panadol) tablets at home in case required.
Overnight after Surgery
Rest quietly. You must have someone there to look after you for the first night.
The Day after Surgery
I will see you in the morning at Hamilton Eye Clinic to check your eye and explain the eye care instructions.
Recovery
Most patients see well enough to return to their routine activities within a day or so after surgery.
Your eye may be slightly irritable, light sensitive and red for the first week or so. This will gradually improve.
Glasses are updated after six weeks.
Follow-Up Visits
- One to three weeks (with me) to check all is well.
- Six weeks (with your Optometrist) to prescribe glasses.
- Again with me as required.
Risks
Thanks to recent advances, cataract surgery gives improvement in vision in over 97% of eyes and is without serious complication in more than 98% of cases. Before undergoing cataract surgery it is essential that you understand the risks involved.
Though cataract surgery is one of the safest forms of surgery, all surgical procedures have risk.
I attempt to minimize risk but complications can occur that may have permanent effects. When you are making the decision to have surgery, you must keep in mind that I cannot guarantee that surgery will always be successful or that surgery bears no risk. I will not describe at length every possible risk or rare complications. Sometimes such detail can be frightening.
Serious complications are uncommon because of the significant surgical advances in recent years. However, if complications do occur, vision may be impaired or even lost. Some people with certain pre-existing eye conditions are at greater risk. If one eye is blind (or has extremely poor vision), you must very carefully weigh the benefit against the risks of cataract surgery on your only "working" eye.
The risks of cataract surgery include:
- infection inside the eye (less than 1/5000 in our facility)
- bleeding within the eye
- excessive inflammation
- high pressure within the eye
- retained portion of cataract in the eye
- damage to, or dislocation of, the implanted lens
- detachment of the retina
- drooping eyelid
- swelling and clouding of the cornea
- blindness and loss of the eye (this is very rare)
Although most complications resolve following additional treatment and over time, they can affect vision, sometimes permanently.
Capsule Opacification
After surgery, the cataract cannot grow back. However a number of eyes develop a clouding of the lens capsule behind the implant. This is not a complication but a normal healing response in many eyes.
A cloudy capsule can take months or years to develop. You will notice blur or glare.
I can correct this using a laser to create a tiny opening in the capsule which allows light to pass through normally. This procedure is called a capsulotomy. This procedure takes only a few minutes and is painless. The improvement in vision can be seen at once. Complications can occur, but serious complcations are very uncommon.
